By Rob Stein
Washington Post Staff Writer
Wednesday, December 22, 2010; 10:41 PM
The American Civil Liberties Union on Wednesday asked federal health officials to ensure that Catholic hospitals provide emergency reproductive care to pregnant women, saying the refusal by religiously affiliated hospitals to provide abortion and other services was becoming an increasing problem.
In a letter to the Centers for Medicare and Medicaid Services, the ACLU cited the case of St. Joseph's Hospital and Medical Center in Phoenix, which was stripped of its Catholic status Tuesday because doctors performed an abortion on a woman who had developed a life-threatening complication.
"We continue to applaud St. Joseph's for doing what is right by standing up for women's health and complying with federal law," five ACLU attorneys wrote in a letter to Donald Berwick, the CMS administrator, and his deputy, Marilyn Tavenner.
"But this confrontation never should have happened in the first place, because no hospital - religious or otherwise - should be prohibited from saving women's lives and from following federal law."
The letter was a follow-up to a complaint the ACLU sent to CMS in July asking for a federal investigation of similar problems at Catholic hospitals across the country, including refusals to provide emergency contraception to rape victims or perform abortions on women having miscarriages.
"The Bishop's drastic and heavy-handed actions send a chilling message to Catholic hospitals throughout the country, as well as their employees: If hospitals comply with federal law and provide emergency abortion care there will be consequences," the letter states. "The dioceses cannot be permitted to dictate who lives and who dies in Catholic-owned hospitals."
Ellen Griffith, a Medicare spokeswoman, said Wednesday that the ACLU's original complaint was still pending and that officials had not reviewed the latest letter.
Yolanda Gaskins, a spokeswoman for Holy Cross Hospital in Silver Spring, said, "In a tragic case where both the life of the mother and unborn baby are at risk, we would always attempt to save both lives - and if this were not possible, we would save the life we could."
Officials at Providence Hospital and Georgetown University Medical Center in the District said no one was immediately available to comment.
The Phoenix case centers on a woman in her 20s who was 11 weeks pregnant in November 2009 when she developed severe pulmonary hypertension, a life-threatening condition. Doctors concluded that they had no choice but to abort the pregnancy to save her life.
When Bishop Thomas Olmsted of the Roman Catholic Diocese of Phoenix learned of the abortion in May, he announced that a nun involved in the decision, Sister Margaret McBride, had been excommunicated because of her role. Olmsted cited a directive by the U.S. Conference of Catholic Bishops. Olmsted followed up that decision with a letter demanding that the hospital take a number of steps to ensure it was complying with church policy, which led to several months of negotiations between the hospital and the diocese.
In announcing the decision Tuesday, Olmsted said that "subsequent communications" with hospital officials "have only eroded my confidence about their commitment to the Church's ethical and religious directives for healthcare. They have not addressed in an adequate manner the scandal caused by the abortion."
In fact, Olmsted said he had "recently learned that many other violations . . . have been taking place at" facilities operated by Catholic Healthcare West, which owns St. Joseph's, including the provision of birth-control pills and other forms of contraception, sterilizations and abortions "due to the mental or physical health of the mother or when the pregnancy is the result of rape or incest."
"For seven years now, I have tried to work with CHW and St. Joseph's, and I have hoped and prayed that this day would not come, that this decree would not be needed; however, the faithful of the Diocese have a right to know whether institutions of this importance are indeed Catholic in identity and practice," he said.
The 670-bed hospital, established in 1895 by the Sisters of Mercy, does not receive any funding from the diocese and will not change its name. But the decision means that the hospital would have to remove the Blessed Sacrament from its chapel and will no longer celebrate Mass there.
"Though we are deeply disappointed, we will be steadfast in fulfilling our mission," Linda Hunt, St. Joseph's president, said in a statement. "Our caregivers deliver extraordinary medical care and share an unmatched commitment to the well-being of the communities they serve. Nothing has or will change in that regard."
Hunt also defended the original decision to perform the abortion.
"Consistent with our values of dignity and justice, if we are presented with a situation in which a pregnancy threatens a woman's life, our first priority is to save both patients," Hunt said. "If that is not possible, we will always save the life we can save, and that is what we did in this case. We continue to stand by that decision. . . . Morally, ethically, and legally we simply cannot stand by and let someone die whose life we might be able to save."
In a statement, Sister Carol Keehan of the Catholic Health Association of the United States praised St. Joseph's and Catholic Healthcare West for "their long and stellar history in the protection of life at all stages."
"St. Joseph's Hospital and Medical Center in Phoenix has many programs that reach out to protect life. They had been confronted with a heartbreaking situation. They carefully evaluated the patient's situation and correctly applied the Ethical and Religious Directives for Catholic Health Care Services to it, saving the only life that was possible to save," she said.
As more hospitals have been taken over by Catholic hospital chains in recent years, reproductive health advocates have become increasingly concerned that fewer medical centers will provide abortion, contraception and other reproductive services.
"Hospitals that have been Catholic historically are finding stricter interpretation of directives by local bishops, and hospitals that have not been Catholic but are becoming Catholic under mergers are finding administrators who are fearful of permitting procedures that might not be considered appropriate under Catholic doctrine," said Lois Uttley, director of the MergerWatch Project, which monitors Catholic takeovers of hospitals.